Role of antidiabetic agents in type 2 diabetes patients with chronic kidney disease

被引:1
|
作者
Lin, Wei-Ren [1 ]
Liu, Kuan-Hung [1 ]
Ling, Tsai-Chieh [1 ]
Wang, Ming-Cheng [1 ]
Lin, Wei-Hung [1 ]
机构
[1] Natl Cheng Kung Univ Hosp, Dept Internal Med, Div Nephrol, 138 Sheng Li Rd, Tainan 704, Taiwan
关键词
Insulin resistance; Chronic kidney disease; Cardiovascular events; Antidiabetic agents; IMPROVES INSULIN-RESISTANCE; SKELETAL-MUSCLE; GLUCOSE-METABOLISM; OXIDATIVE STRESS; BLOOD-PRESSURE; INFLAMMATION; PIOGLITAZONE; SENSITIVITY; INHIBITORS; ACARBOSE;
D O I
10.4239/wjd.v14.i4.352
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Insulin resistance is a condition in which the target tissues have a decreased response to insulin signaling, resulting in glucose uptake defect, and an increased blood sugar level. Pancreatic beta cells thus enhance insulin production to compensate. This situation may cause further beta cell dysfunction and failure, which can lead diabetes mellitus (DM). Insulin resistance is thus an important cause of the development of type 2 DM. Insulin resistance has also been found to have a strong relationship with cardiovascular disease and is common in chronic kidney disease (CKD) patients. The mechanisms of insulin resistance in CKD are complex and multifactorial. They include physical inactivity, inflammation and oxidative stress, metabolic acidosis, vitamin D deficiency, adipose tissue dysfunction, uremic toxins, and renin-angiotensin-aldosterone system activation. Currently, available anti-diabetic agents, such as biguanides, sulfonylureas, thiazolidinediones, alfa-glucosidase inhibitors, glucagon-like peptide-1-based agents, and sodium-glucose co-transporter-2 inhibitors, have different effects on insulin resistance. In this short review, we describe the potential mechanisms of insulin resistance in CKD patients. We also review the interaction of currently available anti-diabetic medications with insulin resistance.
引用
收藏
页码:352 / 363
页数:12
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